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1003567041
GRACE ELISE KACKSTAETTER
NORTHGLENN, CO
NPI
1003567041
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor Mental Health
(Licence: CO MFTC.0014626)
Enumeration Date
2022-01-11
Last Update Date
2024-09-25
Business Address
GRACE ELISE KACKSTAETTER MA, MFTC
10190 BANNOCK ST STE 120
NORTHGLENN, CO 80260-6052
Phone number: 970-460-8009
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Mailing Address
GRACE ELISE KACKSTAETTER MA, MFTC
830 MT SNEFFELS AVE
SEVERANCE, CO 80550-4888
Phone number: 801-708-3673
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